• 제목/요약/키워드: Medical conflict

검색결과 271건 처리시간 0.026초

초고령사회 전환기에 노인범죄 발생원인과 그 대책에 관한 연구 (A Study on the Causes of Elderly Crime and Its Countermeasures in the Transition of Elderly Society)

  • 양재열;김상수;이주연
    • 시큐리티연구
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    • 제61호
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    • pp.307-332
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    • 2019
  • 최근 우리사회는 의료환경의 발전과 생활환경의 개선 등으로 수명의 연장과 함께 저출산으로 인하여 급격한 인구구조의 변화를 불러오고 있다. 급기야 인구의 고령화를 초래하였고 노인문제는 세대간 갈등으로 증폭되고 있다. 현세대 노인은 자식의 교육·결혼과 주거 문제 등으로 자신의 노후 소득보장을 준비할 여력이 없었고, 공적 소득보장의 혜택으로부터 소외된 세대이다. 또한 급속한 산업화와 정보화, 경제적 불안 등과 함께 빈곤상태에 놓여 있음은 물론 생계까지 위협받고 있다. 물질만능이 지배하는 우리사회에 적응력이 떨어진 노인들로부터 발생되는 노인범죄의 증가상황은 새로운 사회문제로 부각되고 있다. 본 연구에서는 고령화 속도가 세계적으로도 유례가 없을 정도로 빠르게 진행되고 있는 우리사회의 노인범죄에 대한 사회적 논의를 통해 국가적인 대처방안 제시가 필요한 시기라 판단하면서 양적 증가와 함께 질적으로는 흉폭화, 난폭화 되고 있는 노인범죄의 원인을 분석하고 10년간의 자료를 이용하여 범죄현황과 예방책을 제시하고자 한다. 본 연구목적 달성을 위하여 노인의 기준이 변화되고 있는 우리사회의 다양한 의견과 통계자료를 고찰하고 범죄의 분석은 대검찰청과 경찰청, 통계청의 자료와 최근 언론 보도 자료, 기존 연구자료 등을 활용하는 문헌연구를 하였다. 본 연구는 노인의 특성과 현 사회가 노인을 보는 시각 등 다양한 측면에서 노인범죄를 진단하여 향후 범죄 발생 예측과 아울러 예방을 위한 발전 방향을 모색해 보고자 한다.

센서 데이터의 압축을 위한 시간 슬롯 할당 기법 (A Time Slot Assignment Scheme for Sensor Data Compression)

  • 여명호;김학신;박형순;유재수
    • 한국정보과학회논문지:컴퓨팅의 실제 및 레터
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    • 제15권11호
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    • pp.846-850
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    • 2009
  • 최근 환경 모니터링, 스마트 빌딩, 의료 분야, 농업 분야 등에서 센서 네트워크가 널리 활용되고 있다. 센서 노드는 배터리로 동작한다. 넓은 지역에 배포된 센서 노드의 배터리를 주기적으로 교체하는 것은 불가능하기 때문에 에너지는 센서 네트워크에서 가장 중요한 자원이다. 따라서, 센서 데이터를 수집하는 동안 네트워크 수명을 연장시키기 위한 에너지 효율적인 메커니즘에 대한 연구는 필수적이다. 대표적인 연구로는 송수신하는 데이터의 크기를 줄이기 위한 데이터 압축 기법과 통신간 충돌을 방지하여 에너지 사용의 효율을 높이기 위한 MAC 프로토콜 기법이 있다. 기존 데이터 압축 기법은 센서 데이터의 공간 또는 시간적인 연관성을 이용하며, 기존 MAC 프로토콜은 TDMA, FDMA, CDMA 등의 방법을 통해 데이터의 충돌을 방지한다. 본 논문에서는 MAC 프로토콜 중 하나로 널리 사용되고 있는 TDMA 스케줄을 조정하여 송수신되는 센서 데이터의 크기를 줄이는 새로운 압축 기법을 제안한다. 제안하는 기법은 데이터 전송 시점을 이용하여 센서의 측정값을 인코딩하여 데이터의 크기를 줄이고, 동적으로 시간 슬롯을 할당함으로써 발생되는 전송 지연을 줄인다. 시뮬레이션을 통해 제안하는 기법의 성능 평가를 수행하였으며, 실험 결과, 기존 데이터 수집 기법에 비해 통신 비용이 약 52% 감소하였다.

간호대학생의 COVID-19에 대한 윤리적 의사결정, 도덕적 민감성 및 감염관리 수행도와의 관련성 (Relationship between Ethical Decision-Making, Moral Sensitivity and Infection Control Performance of Nursing Student's on COVID-19)

  • 이미향;이주연
    • 디지털융복합연구
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    • 제20권3호
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    • pp.359-366
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    • 2022
  • 본 연구는 COVID-19 유행상황에서 간호대학생의 윤리적 의사결정, 도덕적 민감성 및 감염관리 수행도와의 관계를 파악하여 간호대학생의 감염관리 수행도를 높이기 위한 중재방법의 기초자료를 제공하기 위함이다. 간호대학생 3,4학년을 대상으로 구조화된 설문지를 이용하여 일반적 특성, 전공 관련 특성, 윤리적 의사결정, 도덕적 민감성 및 수행도를 조사하였다. 자료분석은 IBM SPSS21.0 프로그램을 이용하여 기술통계, Indepentent t-test, One-way ANOVA, Pearson's correlation coefficient, Stepwise Multiple regression anlaysis를 하였다. 본 연구결과 COVID-19 감염관리 수행도에 영향을 미치는 요인으로 윤리적 의사결정에서 선행의 원칙, 도덕적 민감성에서 갈등과 환자중심간호로 나타났다. 앞으로 신종감염병이 출현할 가능성이 높은 상황에서 예비의료인인 간호대학생의 감염관리 수행도를 향상시키기 위해서는 환자중심의 간호윤리를 강화할 수 있는 실무중심의 융복합적인 교육프로그램을 개발하는 것이 필요하다.

조선족 간병인의 문화적응 경험에 관한 연구: 노인 간병서비스를 제공하는 조선족 여성을 중심으로 (A Study of the Acculturation Meaning among Chinese-Chosun Residential Care Attendants in Long-Term Care Setting)

  • 홍세영;김금자
    • 한국노년학
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    • 제30권4호
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    • pp.1263-1280
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    • 2010
  • 본 연구의 목적은 조선족 간병인의 문화적응 경험에 관한 연구이다. 연구 분석은 Berry(1987)의 문화적응 단계를 인용하여 접촉단계, 갈등단계, 해결 단계로 나누어 조선족 간병인들이 각 단계에서 어떤 경험을 하는지 그 의미를 질적연구 방법을 통해 분석하였다. 접촉단계에서 조선족 간병인은 간병인에 대한 긍정적인 이미지 전환과 연륜의 직업에 의미를 부여하였다. 간병인을 시작하기 전 연구 대상자들은 주변사람들의 영향으로 간병인에 대한 인식이 긍정적으로 변화됐으며, 연령이 많아짐에 따라 간병인이 적합한 일자리가 되었다. 갈등단계에서 조선족들은 차별, 문화적 갈등, 힘든 업무, 부정적 이미지, 타지에서 외로움을 경험하였다. 차별의 경우 조선족이라는 이유만으로 거부와 임금 차별이나 근로조건 등에서 한국인 간병인보다 더 열악한 수준에서 일하는 경우가 많고, 육체적, 정신적으로 힘든 어려움을 경험하고 있었다. 게다가 주위 친지나 가족으로부터 간병인에 대한 부정적 이미지로 인해 내외적 갈등을 경험하기도 했으며, 중국에 거주하는 가족과 떨어져 있기 때문에 외로움을 경험하고 있었다. 이러한 어려움에도 불구하고 해결단계에서 간병인으로 종사하면서 얻는 직간접적인 사회경제적 정서적 혜택은 그들이 한국사회에 적응하는데 큰 역할을 하고 있는 것으로 나타났다. 그 이유로는 이들이 경제적 요인, 일의 보람, 환자 및 보호자 그리고 동료들과의 친분, 일의 자유로움, 일의 안정성, 자부심에서 찾을 수 있었다.

만성통증 환자의 통증 조절 (Chronic pain control in patients with rheumatoid arthritis)

  • 은영
    • 근관절건강학회지
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    • 제2권1호
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    • pp.17-40
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    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

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의사의 전원의무(轉院義務) 위반 여부의 판단기준과 전원시점 판단 - 판례의 동향을 중심으로 - (A Study on the Decision Point and a Standard of Judgment under the Duty of Inter-hospital Transfer for Patients of Doctor - Focused on the Trend of Supreme Court's Decisions -)

  • 최현태
    • 의료법학
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    • 제20권1호
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    • pp.163-201
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    • 2019
  • 의사에게는 환자와의 법률관계에서 비롯되는 여러 의무들이 존재한다. 그 중 하나가 의사 자신이 속해 있는 의료기관이 치료 및 진료를 위한 인프라나 의료기술이 부족한 것으로 판단하는 경우 환자를 적절한 진단 검사 및 진료가 가능한 의료기관으로 '전원(轉院)'하여야 하는 주의의무인 전원의무(轉院醫務)이다. 의료기관마다 환자의 응급성 정도에 따라 대응할 수 있는 능력이 다르므로 의사의 지시나 권고에 의하여든 환자 본인의 요청에 의하여든 이와 같은 환자의 전원은 불가피한 현상이다. 예를 들어 심각한 뇌손상을 입은 환자가 내원한 경우, 진단, 검사 장비 및 인력을 갖추지 못한 병원의 의사로서는 적절한 시기(이른바 '골든타임')에 진단, 검사 및 진료가 가능한 상급의료기관으로 전원을 고려하여야 한다. 이처럼 전원의무는 의사의 의무 중 하나인 것으로 의사뿐만 아니라 환자들에게도 널리 인식되고 있다. 그러므로 적절한 전원 시점을 놓치게 되어 의료사고가 발생한 상황에서는 전원의무위반 여부와 관련한 의사와 환자 간의 법적 분쟁이 있을 수밖에 없다. 본 연구에서는 이러한 상황과 관련하여 전원의무에 대한 구체적이고도 명확한 판단 기준 정립과 함께 현재 각 의료기관들에 마련되어 있는 가이드라인이 실제 적용에서의 여러 시행착오들을 반영하고 있는지에 대한 검토가 필요하다고 보고, 의사의 전원의무에 대한 판례의 동향 분석을 중심으로 전원의무 관련 판례에서 이미 제시되어 있는 판단 기준 요소들이 적절한지 그리고 현재 실무에서 적용되는 법령 및 가이드라인 등과 부합되는지 여부를 살펴봄으로써 앞으로 응급환자에 대한 의사의 전원의무 관련 분쟁조정 및 소송에서의 해석과 적용에 기여할 수 있도록 하였다.

임상시험심사위원회(Institutional Review Board)의 임상시험에 대한 위험평가 분류조사연구 (Survey of Institutional Review Board Risk Level Classification of Clinical Trials Among Korean University Hospitals)

  • 이선주;강수진;맹치훈;신유진;유소영
    • 대한기관윤리심의기구협의회지
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    • 제4권2호
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    • pp.36-41
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    • 2022
  • Purpose: The purpose of this study is to evaluate how university hospital Institutional Review Boards (IRBs) in Korea classify risk when reviewing clinical trial protocols. Methods: IRB experts (IRB chairman, vice chairman, IRB administrator) in the university hospitals obtaining a Human research protection program (HRPP) or IRB accreditation in Korea were asked to fill out the Google Survey from September 1, 2020 to October 10, 2020. Result: Among the 23 responder hospitals, 8 were accredited by the American Association for Human Research Protection Program (AAHRPP) and 8 were accredited by the HRPP of Ministry of Food and Drug Safety (MFDS). Seven were accredited by Forum for Ethical Review Committees in Asia and the Western Pacific or Korea National Institution for Bioethics Policy. Thirteen of 23 hospitals (56.5%) had 4 levels (less than minimal, low, moderate, high risk), 4 hospitals had 3 levels (less than, slightly over, over than minimal risk), 1 hospital had 5 levels (4 levels plus required data safety monitoring board), and 1 hospital had 2 levels (less than, over than minimal risk) risk classification system. Thirteen of 23 hospitals (56.5%) had difficulty classifying the risk levels of research protocols. Fourteen hospitals (60.9%) responded that different standards among hospitals for risk level determination associated with clinical trials will affect the subject protection. Six hospitals (26.1%) responded that it will not. Three hospitals (13.0%) responded that it will affect the beginning of the clinical trial. To resolve differences in standards between hospitals, 14 hospitals (60.9%) responded that either the Korean Association of IRB or MFDS needs to provide a guideline for risk level determination in clinical trials: 5 hospitals (21.7%) responded education for IRB members and researchers is needed; 3 hospitals (13.0%) responded that difference among institutions needs to be acknowledged; and 1 hospital (4.3%) responded that there needs to be communication among IRB, investigator, and sponsor. Conclusion: After conducting a nationwide survey on how IRB in university hospital determines risk during review of clinical trials, it is reasonable to use 4-level risk classification (less than minimal, low, moderate, high risk); the most utilized method among hospitals. Moreover, personal information and conflict of interest associated with clinical trials have to be considered when reviewing clinical trial protocols.

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한의학적(韓醫學的) 대상관(對象觀)의 특징과 성격 (The Characteristic and Implication of the View of Object in Oriental Medicine)

  • 이충열
    • 대한한의학회지
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    • 제16권1호통권29호
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    • pp.505-530
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    • 1995
  • Recently some people in learned circles of oriental medicine raised a Question about a terminological problem, i.e., 'oriental medical'. This question was thought as an attempt to find out the identity of oriental medicine which exists among the various current medical knowledge systems. In spite of same object, human body, there are diverse medical knowledge systems which has different concepts and theories. This come from the difference of a view of object which defines the experiences of that. The knowledge system of oriental medicine was established by the view of object in oriental medicine which depended on the way of thinking as Yin and Yang. The view of object in oriental medicine has come out in the special cultural soil, namely, the oriental world. Because of this the view of object in oriental medicine cannot be seperated from the oriental world view. What distintive feature does the oriental world view have? It can be summarized as the holistic, dynamical and organic ideas of the world. The term 'oriental medical' is being used to emphasize the characteristic and the peculiarity of the oriental medicine among the various medical knowledge systems. Can the current so called scientific method accept this peculiar and special method of oriental medicine? The efforts of philosophers who had been stimulated by the awful scientific achivements and had tried to find out the unified method penetrating through all the empirical science by mobilizing the logic and mathematics has became out of date for the raise of a question about the inductive method. On the contrary, the theses of theory-laden observation was accepted widely and the relativism was accepted as a new established theory. But the relativism has its own problem. The relativism was founded upon the concept, the incommensurability, which Khun and Feyerabend had proposed. This concept was criticized strongly by some of philosophers because of its own self-refuting. The view of object in oriental medicine has a relative characteristic in the aspect of its urge that in accordance with the perspective a different medical knowledge system can be possible. But our possible choice is the moderate conceptual relativism. Therefore if the view of object in oriental medicine includes the relative aspect, there is the 'conceptual relativity' between the knowledge system of oriental medicine and the western medicine. This preview an important aspect for the standardization and modernizing research of oriental medicine by lending the knowledge of the western medicine. And when we choose the moderate conceptual relativism, it means that we do not support the extreme relativism, that is, 'anything goes'. The concept of truth and rationality cannot be abandoned, and it plays the role of the norm on the knowledge system of oriental medicine and other knowledge systems of medicine in a limited meaning. And the view of object in oriental medicine has an organic view about the human body and the characteristic which wants to interpret the phenomena of human body by using the holistic method. But the availability of this method will be evaluated by the achievements of oriental medicine. Finally what relationship does the theory of oriental medicine have with the world the theory is applied to? It is recognized that the theory of oriental medicine has the instrumental characteristic. But it can be thought the instrumentalism is different from the oriental medical standpoint in the aspect that the instrumentalism seperates the theoretical existence from the observational existence sharply. Because in the oriental thinking way there is no seperation between the mind of observer and the object and no conflict between the idealism and the realism like the western world. For this problem there must be a further study.

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건강보험 체납예측모형을 통한 체납세대의 유형화 및 특성 (Categorized the Contribution evasion through Health Insurance contribution evasion expected model)

  • 이애경;최인덕
    • 보건행정학회지
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    • 제14권2호
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    • pp.78-98
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    • 2004
  • The purpose of this study was to categorize the contribution evasion and develop the expected models for contribution arrears in National Health Care System. The modified logistic regression model in non-payments was used as logistic regression model based on the statistical method. By using this model, we arranged non-payment types and typical branches those are appeared by statistical technique. First fact, sex and age branches those are able to take a part in economy had effect mostly. Also they had difference in non-payment probability by existence of their incomes and property. Especially people who didn't have their own house and car were appeared in high non-payment probability, disease and reduction characteristic(rare diseases, reduction of seniors, handicaps, numbers of medical treatments) didn't effect much in probability. The reason for some characteristic of non-payment which is higher than the correct threshold value of Logistic Regression Model (a suggested model for predicting non-payment)'s distribution of probability was mostly moral hazard. Living difficulty was the bigger reason for non-payment, but moral slackening was the bigger reason for non-payment. But it is careless to decide that moral hazard is just the reason, there is a necessity to examine on the side of sociology based in family. By the reason, the member's non-payment reason can be classified by economy, population, and psychology, but there was a comprehension that losing of work desire could be one reason. So we analyzed informations for composition of family of members. In conclusion, we grasped that family conflict makes non-payment and conversion of member in the National Basic Livelihood Protection System difficult.

전정 신경병증 환자 치험 1례에 대한 고찰 (A Case of Vestibulopathy With Vertigo)

  • 유미경;최정화;김종한;박수연;박용호
    • 한방안이비인후피부과학회지
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    • 제18권2호
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    • pp.93-98
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    • 2005
  • Vertigo occurs when there is conflict between the signals sent to the brain by various balance- and position-sensing systems of the body. Injury to or diseases of the inner ear can send false signals to the brain indicating that the balance mechanism of the inner ear (labyrinth) detects motion. Inner ear disorders, such as benign paroxysmal positional vertigo (BPPV), Meniere's disease, vestibular neuronitis, or labyrinthitis. Vestibular neuronitis is an inflammation of the vestibular nerve, which is located in your inner ear. In this case, She has vertigo occured suddenly and continued even when the person lies completely still. It may be accompanied by nausea and vomiting. She has taken herbal medication and treated by acupunture. Her symptoms become disappeared after 3 days and All most symptoms were disappeard. In conclusion, It is required to classify vestibulopathy into vestibular neuronitis or labyrinthitis. In this case we diagnosed her case as vestibular neuronitis. Her symptoms of vestibulopathy recovered fast by Korean traditional medical therapy.

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